A Review of the Evidence of Harm from Self-Tests

Brown, Annette N.; Djimeu, Eric W.; Cameron, Drew

doi:10.1007/s10461-014-0831-y

Cited by 64 publications

(74 citation statements)

References 28 publications

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“…If the introduction of self-testing kits did lead to such harm, this could constitute a strong objection to them. However, as we have noted earlier, there is little evidence to support this fear 12 22. That said, it would be prudent to monitor for such behaviour now that self-testing kits are available.…”

Section: The Result: Reactivementioning

confidence: 90%

“…People increasingly understand that HIV is a chronic condition, and society is far more accepting than it used to be of those afflicted by the virus 17. As such, evidence suggests that the risk of serious psychological harm from self-testing is now low 22. It is also worth noting that some scholars have thought it implausible to suggest that a short pretest counselling session could significantly dampen the psychological impact of a reactive HIV result 14.…”

Section: Before the Testmentioning

confidence: 99%

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Ethical implications of HIV self-testing

Youngs

Hooper

2015

J Med Ethics

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In April 2015, the first legally approved HIV self-testing kit went on sale in the UK-except Northern Ireland where they remain illegal. These tests allow individuals to test their HIV status and read the result in the privacy of their own home, much like a home pregnancy test. This paper explores the ethical implications of HIV self-testing. We conclude that there are no strong ethical objections to self-testing being made widely available in the UK. Pretest counselling for an HIV test is not an ethical necessity, and self-testing has the potential to increase early diagnosis of HIV infection and thus improve prognosis and reduce ongoing transmission. Self-testing kits might also empower people and promote autonomy by allowing people to dictate the terms on which they test their HIV status. We accept that there are some potential areas of concern. These include the possibility of user error with the tests, and the concern that individuals may not present to health services following a reactive result. False negatives have the potential to cause harm if the 'window period' is not understood, and false positives might produce psychological distress. There is, however, little evidence to suggest that self-testing kits will cause widespread harm, and we argue that the only way to properly evaluate whether they do cause significant harm is to carefully evaluate their use, now that they are available on the market.

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Section: The Result: Reactivementioning

confidence: 90%

Section: Before the Testmentioning

confidence: 99%

Ethical implications of HIV self-testing

Youngs

Hooper

2015

J Med Ethics

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“…As a result, women were able to overcome the initial fears and successfully delivered the kits to their male partners with no serious adverse events reported. Indeed, a review of the evidence of harm from HIV self-tests found that although the potential for harm is discussed in the literature on self-tests, there is very little evidence that such harm occurs [20]. Collectively, our findings and findings from previous studies suggest that women can safely deliver HIV self-test kits to their male partners, and this, in itself, can help to improve HIV-testing rates in men, which is important for identifying HIV-positive men at an early stage in order to link them to appropriate HIV care and treatment services.…”

Section: Discussionmentioning

confidence: 99%

‘If I had not taken it [HIVST kit] home, my husband would not have come to the facility to test for HIV’: HIV self-testing perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda

Matovu

Kisa

Buregyeya

et al. 2018

Global Health Action

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Background: HIV self-testing (HIVST) can improve HIV-testing rates in ‘hard-to-reach’ populations, including men. We explored HIVST perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda. Methods: This was a qualitative study implemented as part of a pilot, cluster-randomized oral HIVST intervention trial among 1,514 pregnant women attending antenatal care services at three health facilities in Central Uganda. The qualitative component of the study was conducted between February and March 2017. We conducted 32 in-depth interviews to document women and men’s perceptions about HIVST, strategies used by women in delivering the kits to their male partners, male partners’ reactions to receiving kits from their female partners, and positive and negative social outcomes post-test. All interviews were audio-recorded, transcribed verbatim, and analyzed manually following a thematic framework approach. Results: Women were initially anxious about their male partners’ reaction if they brought HIVST kits home, but the majority eventually managed to deliver the kits to them successfully. Women who had some level of apprehension used a variety of strategies to deliver the kits including placing the kits in locations that would arouse male partners’ inquisitiveness or waited for ‘opportune’ moments when their husbands were likely to be more receptive. A few (three) women lied about the purpose of the test kit (testing for syphilis and other illnesses) while one woman stealthily took a mucosal swab from the husband. Most men initially doubted the ability of oral HIVST kits to test for HIV, but this did not stop them from using them. Both men and women perceived HIVST as an opportunity to learn about each other’s HIV status. No serious adverse events were reported post-test. Conclusion: Our findings lend further credence to previous findings regarding the feasibility of female-delivered HIVST to improve male partner HIV testing in sub-Saharan Africa. However, support for women in challenging relationships is required to minimize potential for deception and coercion.

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“…Access to HIV testing permits infected individuals to receive early treatment, thus increasing survival rates and reducing morbidity and mortality associated with the virus (16,17). Furthermore, the knowledge of serological status contributes to reducing risk behaviors and viral transmission (17,18).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the knowledge of serological status contributes to reducing risk behaviors and viral transmission (17,18). The rate of HIV transmission is estimated to be 3.5 times greater among individuals who are unaware of their serologic status (19).…”

Section: Introductionmentioning

confidence: 99%